Individual
BRUCE MENDELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
849 NE 7TH STREET, TAI GRANTS PASS, GRANTS PASS, OR 97526-1634
(541) 479-0765
(541) 479-3461
Mailing address
11481 SW HALL BV, THERAPEUTIC ASSOCIATES INC STE 201, PORTLAND, OR 97223-8403
(800) 219-8835
(503) 443-1402
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2220
AR
225100000X
Physical Therapist
Primary
4573
OR
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297999
—
OR
Enumeration date
11/17/2005
Last updated
07/08/2007
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